The predictive power of personality through psychopathology in Alzheimer's disease: a control study of self-report and baseline retrospective assessment.

Although there is a growing body of literature on the Alzheimer's disease (AD) personality changes, its relationships with personality disorders are still largely understudied. The relationships between the Five-Factor Model and the Axis II personality disorders were explored in the context of current and baseline personality in AD. The study was conducted with four groups who were administered the NEO-FFI and the PDQ-4+, mainly in interview sessions. Self-report measurement: AD Group, 40 female participants (M = 81.48 years); Control Group, 47 female participants from the population at large (M = 76.81 years). Baseline retrospective measurement: AD Group Informants (n = 40); Control Group Informants (n = 47). Three logistic regressions were computed. The baseline Neuroticism moderates the Neuroticism in the current clinical state. High Neuroticism, low Openness, high Cluster B, and baseline high Neuroticism, predicted the presence of AD diagnosis, accounting for 85% of the variance. In order to increase sensitivity towards an earlier diagnosis in AD, future empirically-based research should take into account an assessment set of structural personality variables.

Personality disorders characterized by anxiety predict Alzheimer's disease in women: A case-control studies.

This research is geared toward the evaluation of current and pre-morbid personality psychopathology in Alzheimer's disease (AD). The study was conducted with four groups who were administered the Personality Diagnostic Questionnaire-4+, mainly in the form of individual interviews. Current measurement: AD Group, 44 female participants (M = 81.36 years); Control Group, 80 female participants from the population at large (M = 75.84 years). Pre-morbid measurement: AD Group Informants (n = 40); Control Group Informants (n = 42). The incidence of all clusters in clinical state are significant, and Cluster B incidence in pre-morbidity is evidenced. Cluster C is highlighted throughout the life course as a predictor. Logistic regression analyses showed that schizotypical, narcissistic, avoidant, obsessive-compulsive, pre-morbid schizotypical, pre-morbid histrionic, and pre-morbid obsessive-compulsive personality disorders, predicted the presence of AD diagnosis, accounting for 49% of the variance. These findings are relevant to research relating personality and psychopathology in Alzheimer's disease.

Depressive vulnerability in women with Alzheimer's disease: Relationship with personality traits and abnormal personality dimensions.

BACKGROUND: This study sought to determine the evaluation of current and pre-morbid depressive vulnerability dimensions in Alzheimer's disease. Sidney Blatt´s personality developmental perspective, the Five-Factor model and Axis II personality disorders were taken as references. METHODS: The study was conducted with two groups which were assessed using the Depressive Experiences Questionnaire, the NEO-FFI and the Personality Diagnostic Questionnaire-4+, in the form of individual interview sessions. Current personality measure: Alzheimer's disease Group, consisting of 44 female participants (MAge = 81.36 years); Pre-morbid personality measure: Alzheimer's disease Group Informants (n = 40). RESULTS: Self-Criticism personality vulnerability is a general indicator of psychopathology. In pre-morbidity, Neuroticism (ß = 0.41), Agreeableness (ß = -0.63) and Conscientiousness (ß = -0.08) predicted Self-Criticism, explaining 64% of the variance; additionally, Self-Criticism (ß = 0.72) and Neediness (ß = 2.05) predicted the PDQ-4+ total, explaining 58% of the variance. In terms of current personality, the PDQ-4+ total was predicted by Self-Criticism (ß = 0.55), explaining 30% of the variance. LIMITATIONS: The small size of the samples, especially since it is difficult to access individuals diagnosed with AD at the onset or in its early stages; measuring personality changes by means of retrospective assessment by proxies may have introduced some memory bias. CONCLUSIONS: These findings are relevant to research relating depressive vulnerability to personality traits and psychopathology in Alzheimer's disease.

Indicadores de calidad en la terapia intravenosa / Analysis of quality indicators in intravenous therapy

RESUMEN Introducción: Los eventos adversos son comunes durante el uso de la terapia intravenosa, pueden causar daño al paciente y contribuir a agravar el estado de salud y la estancia hospitalaria prolongada. Además, al proporcionar acceso directo a la corriente sanguínea, los eventos adversos relacionados con la terapia intravenosa pueden tener repercusiones más graves y perjudiciales. Objetivo: Analizar indicadores de calidad relacionados con la atención de salud en la terapia intravenosa en un hospital público y de enseñanza. Métodos: Estudio descriptivo-exploratorio, transversal realizado en un hospital público, de enseñanza. Para recopilar datos se utilizó una forma adaptada compuesta por 03 indicadores: identificación de acceso venoso periférico, la identificación de goteo intravenoso para botellas de infusión y la identificación de suero y control de la velocidad de infusión de las soluciones. La muestra, intencional, consistió en 94 participantes. Resultados: Se realizaron 1 355 observaciones. De éstas, 439 fueron el acceso venoso periférico, 463 de los catéteres para la infusión intravenosa de 453 botellas de suero y medicamentos. La validez de un acceso venoso periférico, basado solo en accesos identificados correctamente, fue el único cuyo resultado de calidad de la atención (QA) era deseable (100 por ciento) y segura (83,3 por ciento); todos los demás mostraron QA mal (< 70 por ciento). Conclusión: Los resultados encontrados en este estudio están por debajo del deseado para que una asistencia de calidad en terapia intravenosa sea garantizada. La calidad de la atención en la terapia intravenosa es mucho menor que la recomendada(AU)

ABSTRACT Introduction: Adverse events are common during use of intravenous therapy can cause damage to the patient, and contribute to worsening health status and prolonged hospital stay. In addition, by providing direct access to the bloodstream, adverse events related to intravenous therapy may be more serious and harmful repercussions. Objective: To analyze the quality indicators related to health care in intravenous therapy in an extension public research teaching hospital. Methods: Descriptive and exploratory, cross-sectional study in a public hospital, teaching. For data collection, it was used an adapted form composed of 03 following indicators: identification of peripheral venous access, equipment used for intravenous infusion, serum bottles, and speed control of infusion solutions. The intentional sample was consisted of 94 participants. Results: 1355 observations were done.In these observations, 439 were of peripheral venous access, 463 of equipment used for intravenous infusion, 453 of serum bottles and medicine. Based only on properly identified access, the validity of peripheral venous access was the only one whose result of quality of care (QA) was desirable (100 percent) and safe (83,3 percent), all the others showed QA poorly (< 70 percent). Conclusions: The results found in this study are below desired for quality care in intravenous therapy is ensured. The quality of care in intravenous therapy is very lower than recommended(AU)

Uma revisão exploratória na demência e esquizofrenia: sobreposições, diferenças e personalidade psicodinâmica / An exploratory review on dementia and schizophrenia: overlaps, differences and psychodynamic personality / Una revisión exploratoria en la demencia y la esquizofrenia: superposiciones, diferencias y la personalidad psicodinámica

Neste estudo são salientadas algumas das sobreposições e diferenças na demência e esquizofrenia. A análise entre uma estrutura psíquica de personalidade e os respetivos diagnósticos é o objeto de exploração desta revisão. A angústia de fragmentação e a relação de objeto fusional apresentam-se relacionadas com a esquizofrenia e, por seu turno, a angústia de abandono e a relação de objeto anaclítica com a demência. Num continuum, a estrutura psicótica surge associada à esquizofrenia e a estrutura borderline à demência.

This study sets out to review some of the overlaps and differences in dementia and schizophrenia, and to analyze the relationship between a specific personality structure and diagnosis. The anxiety of abandonment and the anaclitic object relationship are related to dementia, while the anxiety of fragmentation and fusional object relationship are associated with schizophrenia. On a continuum, the borderline structure appears associated with dementia and the psychotic structure with schizophrenia.

En este estudio se destacan algunas de las superposiciones y diferencias en la demencia y la esquizofrenia. El análisis de una estructura psíquica de la personalidad y el diagnóstico respectivo es objeto de revisión. La angustia de la fragmentación y la relación de objeto fusional parecen estar relacionadas con la esquizofrenia y, a su vez, el angustia de la abandono y la relación de objeto anaclítica con la demencia. En el continuum, la estructura psicótica aparece asociada con la esquizofrenia y la demencia con la estructura borderline.

Personality disorders as an expression of the dimensional polarity in personality development in late adulthood women.

Relationships between Axis II personality disorders and Sidney Blatt constructs of dependency and self-criticism were explored in a late adulthood women sample. The sample consisted of 102 women (M = 72.07 years of age, SD = 7.04) who were administered two measures, the Personality Diagnostic Questionnaire-4+ and the Depressive Experiences Questionnaire. The histrionic, dependent, and obsessive-compulsive personality disorder scales are shown to be significant predictors of dependency, and the narcissistic, borderline, and avoidant scales are significant predictors of self-criticism. The application of a dimensional interpersonal approach to psychopathology is discussed.

Five-factor model personality domains in the prediction of Axis II personality disorders: an exploratory study in late adulthood women non-clinical sample.

Relationships between Axis II personality disorders (DSM-IV) and the five-factor model were explored in a non-clinical sample of late adulthood women. The sample consists of 90 women (M = 72.29 years of age, standard deviation = 7.10), who were administered with two measures, the NEO-FFI and the Personality Diagnostic Questionnaire-4+. Some personality disorders scales such as paranoid, schizotypal, borderline and dependent demonstrate a differentiated pattern of five-factor model domain predictors. Low agreeableness predicted schizoid, narcissistic and antisocial; histrionic, obsessive-compulsive and negativistic were predicted by high neuroticism and low agreeableness; high neuroticism and low extraversion, in turn, predicted dependent and depressive scales. Also, two clusters of personality disorders are identified, one associated with low agreeableness and another with low agreeableness and high neuroticism. This study suggest that some traits become maladaptive personality traits, and correspond more closely to psychopathology, when they become opposite to what would be expected in line with studies in normal late adulthood development.

Personality traits and personality disorders in older women: an explorative study between normal development and psychopathology.

The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of 90 participants (M = 72.29 years, SD = 7.10) who were administered the NEO-Five-Factor Inventory and the Personality Diagnostic Questionnaire. The highest prevalence of A and C clusters and obsessive-compulsive personality disorder was observed. Also, elevated neuroticism and decreased agreeableness and openness appear as valuable traits in the description of psychopathology. The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning, extending the range of psychopathology to a dimensional approach.

Predicting relatedness and self-definition depressive experiences in aging women based on personality traits: a preliminary study.

As part of the research relating personality and depression, this study seeks to predict depressive experiences in aging women according to Sidney Blatt's perspective based on the Five-Factor Model of Personality. The NEO-Five Factor Inventory and the Depressive Experiences Questionnaire were administered. The domains Neuroticism, Agreeableness, and Conscientiousness predicted self-criticism, explaining 68% of the variance; the domains Neuroticism and Extraversion predicted dependency, explaining 62% of the variance. The subfactors Neediness and Connectedness were differently related to personality traits. These findings are relevant to the research relating personality and anaclitic / introjective depressive experiences in late adulthood.

A esquizofrenia e a demência no Teste de Apercepção Temática: uma análise da angústia e da relação de objeto / Schizophrenia and dementia in the Thematic Apperception Test: an angst and object relation analysis

Este estudo recupera empiricamente, por meio das lentes da psicologiapsicanalítica, a discussão clássica entre a esquizofrenia e a antiga defi niçãodementia praecox. O objeto de exploração é o da análise da possível associação entre uma estrutura de personalidade específi ca e os diagnósticos de esquizofrenia e demência, em termos da caracterização da angústia e da relação objetal.Amostra do estudo constituída por 58 participantes do sexo feminino, tendo30 o diagnóstico de esquizofrenia (M = 68.83 anos de idade, DP = 8.13) e 28, odiagnóstico de demência (M = 83.36 anos de idade, DP = 7.51). Os instrumentos de avaliação psicológica utilizados são a prova projetiva TAT (Murray, 1973; Shentoub, 1999) e o Manual for the Measurement of Symbiosis in Human Relationship(Summers, 1978). A angústia de fragmentação e a relação de objetofusional apresentam-se relacionadas com a esquizofrenia e, por seu turno, aangústia de abandono e a relação de objeto anaclítica, com a demência. Estruturas psíquicas de personalidade específi cas parecem estar associadas com os diferentes diagnósticos. Num continuum, a estrutura psicótica surge associada à esquizofrenia, e a estrutura borderline, à demência. Discutem-se aspectos suscitados pelo estudo e propõem-se sugestões para futuras investigações. (AU)

Within the scope of Psychoanalytic Psychology, this study empiricallydraws on aspects of the classical discussion between the schizophrenia and the former denomination, dementia praecox. The aim of this research study is to explore a possible association between a specifi c psychic personality structure and the diagnoses of schizophrenia and dementia, in terms of angst and object relation patterns. The sample consisted of 58 female participants, 30 participants diagnosed with schizophrenia (M = 68.83 years of age, SD = 8.13) and 28 participantsdiagnosed with dementia (M = 83.36 years of age, SD = 7.51). The instruments used for psychological assessment were the projective test TAT (Murray, 1973; Shentoub, 1999) and the Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978). The fragmentation angst and the fusional object relation are associated with schizophrenia and, in turn, the abandonment angst and the anaclitic object relation with dementia. It was assumed that specific psychic personality structures were associated with the diff erent diagnoses. In a continuum, the psychotic structure is connected with schizophrenia and, theborderline structure with dementia. The discussion highlights signifi cant issuesof this study. Some suggestions for further research have been proposed. (AU)

El sarcoma cardiaco ¿simula lupus eritematoso y vasculitis? Informe de 2 casos / Heart sarcoma mimicks systemic lupus erythematosus? Report of 2 cases

Los tumores primarios del corazón son raros. El más común es el mixoma, que es capaz de sintetizar IL-6 y con frecuencia tiene manifestaciones sistémicas, que confunden el diagnóstico. Los sarcomas cardiacos primarios, aún más raros, nunca han sido asociados a enfermedad sistémica. Informamos dos casos, en donde el diagnóstico presuntivo de lupus eritematoso sistémico fue modificado ante el hallazgo de sarcomas cardiacos primarios de estirpe muscular

Antibioticoterapia profiláctica en cirugía artopédica: estudio clínico comparativo de dos protocolos de administración con el uso de la combinación de cefradina y amikacina / Antibiotics theraphy prophylactics in surgery orthopaedic: study clinical comparative of two protocol of administration with the use of the combination of cephradine and amikacin

Se valoró la evolución postoperatoria de 119 pacientes que fueron objeto de reducción y osteosíntesis con enclavado intramedular (Kuntscher) de fracturas cerradas no complicadas de femur y tibia. La muestra se dividió al azar en dos grupos: 54 sujetos recibieron cefradina combinada con amikacina antes de la operación y durante 48 horas del postoperatorio (protocolo A); en los 55 restantes se administraron cefradina y amikacina luego del acto quirúrgico (protocolo B). Se encontró que 103 (94.5 por ciento) pacientes no presentaron infección postoperatoria, en tanto seis (5.5 por ciento) sí lo hicieron. De los 54 sujetos incluidos en el protocolo A, solamente se infectó uno (1.85 por ciento) no así los otros 53 (98.15 por ciento). De los 55 pacientes que recibieron el protocolo B, cinco (9.09 por ciento) presentaron infección, no así los otros 50 (94.5 por ciento). Los resultados demostraron una tasa de infección menor en individuos que recibieron el protocolo A, que en los que se incluyeron en el B. Aunque no se encontraron diferencias estadísticamente significativas, es importante reconocer que es innecesario prolongar la adminsitración de antibióticos. Se concluye que es posible considerar a la combinación de cefradina-amikacina administrada antes de la intervención y durante 48 horas después, como un esquema terapéutico eficaz para prevenir infeccones en cirugía ortopédica de fracturas cerradas

Alfafetoprotéina em líquido amniótico de gestantes brasileiras / Alphafetoprotein in amniotic fluid of Brazilian pregnant women

Neste trabalho, apresentamos intervalos de referência para a concentraçäo de alfafetoprotéina (AFP) em líquido amniótico (LA) de gestantes brasileiras de alto risco. O conhecimento destes valores em várias idades gestacionais é um pré-requisito para o diagnóstico dos defeitos de fechamento do tubo neural, dentre outras malformaçöes fetais graves. As alteraçöes de tubo neural representam os primeiros exemplos de defeitos multifatoriais passíveis de serem diagnosticados "intra utero", graças à dosagem de AFP. Este é um trabalho pioneiro no Brasil e acreditamos que a AFP possa ser dosada nas condiçöes existentes nos laboratórios brasileiros, através do sistema de imunoeletroforese em "rocket". Esta determinaçäo possibilita o diagnóstico precoce de certas anomalias fetais graves, cuja importância, em nosso meio, näo deve ser desprezada